In Silico Modelling of Right Continuous Flow Circulatory Support to Simulate RVAD Assistance

Introduction: Right ventricular failure occurs in multiple settings in-cluding acute myocardial infarction, acute decompensated heart failure, fulminant myocarditis, acute pulmonary embolism, decompensated pulmonary hypertension and in post-cardiotomy shock. Mechanical circulatory support with a continuous flow device is often used to support a failing right ventricle. Computer simulation can be a useful tool to study the effects induced by the right ventricular assist device on the failing ventricle. In this chapter, we present simulation results regarding the effects produced by the device on some haemodynamic and energetic variables when different pump speed values were applied to the native right ventricle. Methods: The simulations were performed using CARDIOSIM© car-diovascular software simulator assembled with rotary blood pump as-sistance (Hemopump). The software has been developed using lumped parameter models in order to simulate important hemodynamic interactions between a right ventricular assist device and the native circulation. The Starling's law of the heart was reproduced using variable elastance model for both ventricles. Results: According to literature data, the rotational speed of the pump heavily affects right ventricular end-diastolic and end-systolic volumes, right ventricular output flow, mean right atrial pressure and the artificial ventricular pump output flow. Effects on mean pulmonary arterial pressure can be observed too. All mean haemodynamic values were calculated during the cardiac cycle. The total flow (native right flow + Hemopump flow) increased when the speed of the pump increased. Conclusions: Simulations results obtained without and in the presence of the Hemopump, are in good agreement with literature reports. The Hemopump produced a rise in total flow, a drop in blood flow ejected by the native right ventricle and a drop in mean right atrial pressure